MEDICARE: MARIA FERNANDA BUITRAGO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	PS59687	FL

General Provider Information

NPI Number	:	1710533062
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA FERNANDA BUITRAGO

Provider Business Mailing Address
First Line	:	5888 TIMBER VALLEY DR
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33463-6771
Country	:	US
Telephone Number	:	561-601-2127
Fax Number	:

Provider Business Practice Location Address
First Line	:	4849 S MILITARY TRL
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33463-5310
Country	:	US
Telephone Number	:	561-304-2727
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/13/2019
Last Update Date	:	08/13/2019

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